ALK-fusion lung adenocarcinoma with pleural progression: alectinib toxicity and switch to lorlatinib

Patient Info: Anonymized, Male, 50s | Stage IV

Biomarkers: EML4::ALK fusion positive

Metastatic Site: pleura

After pleural progression, disease was stable on ALK-targeted therapy; lorlatinib was tolerated after alectinib-related hemolysis and bradycardia resolved.

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EGFR L858R lung adenocarcinoma presenting as rectal and peritoneal metastases

Patient Info: Anonymized, Male, 70+ | Stage IV

Biomarkers: Rectal/peritoneal tumors supported lung origin. Key result: EGFR L858R with TP53 mutations; no other actionable lung alteration reported.

Metastatic Site: rectum; peritoneum; omentum; mesentery; colonic wall

After transverse colostomy and confirmation of EGFR L858R-mutant lung adenocarcinoma metastasis, aumolertinib led to clinical stabilization; palliative radiotherapy was later given to the rectal lesion, but long-term follow-up was not yet available.

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Stage IV Colorectal Cancer: Starr's Survivor Story

Patient Info: Starr, Female, 40s | Stage IV

Metastatic Site: Liver; peritoneum; lymph nodes

Starr had Stage IV colon cancer involving the liver, peritoneum, and lymph nodes. After chemotherapy, targeted therapy, and 2 surgeries in early 2025, she was told scans and circulating-tumor testing showed no visible cancer. As of October 2025, she described being in remission.

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Stage IV Ovarian Cancer: Evelyn's Survivor Story

Patient Info: Evelyn, female | Stage IV

Biomarkers: HRD-positive

After chemotherapy and surgery, Evelyn reported an unremarkable final scan in May 2023 and then completed 2 years of Lynparza maintenance therapy guided by HRD-positive tumor testing.

The Cancer Spread One Year Later…

Patient Info: Kalei, Female, Under 40 | Stage IV

Metastatic Site: Lungs; bilateral lung nodules

Kalei initially had Stage II rectal cancer that responded to chemoradiation and IV chemotherapy without rectal surgery. In 2025, biopsy-proven lung metastasis changed the diagnosis to Stage IV. As of October 2025, she had undergone lung resections with clear margins and remained in ongoing follow-up rather than having a clearly stated NED status.

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Luminal A solid papillary breast carcinoma with lung metastasis: mastectomy and lung resection, PET-CT clear

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: Initial breast tumor and lung metastasis were ER/PR positive, HER2 0

Metastatic Site: lung

About 40 days after lung surgery, PET-CT showed no abnormalities; the specialist recommended regular follow-up without additional antitumor drug therapy, and she was alive and in good condition.

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Kidney complication after switching colorectal cancer chemotherapy regimens

Patient Info: Anonymized, Male, 70+ | Stage IV

Metastatic Site: liver

The cancer had worsening liver metastases when FTD/TPI began. After treatment was stopped, steroid therapy resolved edema within 1 month and proteinuria returned to baseline 2.5 months after admission; the later cancer course was not established.

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Stage IV lung adenocarcinoma with paraneoplastic nephrotic syndrome during pembrolizumab therapy

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: PD-L1 tumor proportion score >50% by Roche SP263 assay; KRAS exon 3 mutation; NGS/FISH did not identify targets for first-line targeted therapy

Metastatic Site: brain, bone

Pembrolizumab produced partial response and improved nephrotic-syndrome parameters, but bone metastases progressed in September 2022 and the right upper-lobe target lesion progressed 2 months later, leading to carboplatin plus pemetrexed.

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Stage IV Breast Cancer: Dana's Patient Story

Patient Info: Dana, Female, 50s | Stage IV

Metastatic Site: Liver; bones; lymph nodes

As of October 2025, Dana was living with stable Stage IV metastatic breast cancer involving the liver, bones, and lymph nodes, controlled with targeted therapy and hormone blockers while also managing bipolar disorder and treatment-related mental health effects.

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Stage IVA right lung squamous cell carcinoma: partial response complicated by camrelizumab-related pneumonitis and pulmonary bullae

Patient Info: Anonymized, Male, 70+ | Stage IV

Biomarkers: Squamous lung cancer marker profile: P40/CK5/6 positive, TTF-1/Napsin A negative. CEA/CYFRA tumor markers were elevated. PD-L1 not reported.

Metastatic Site: suspected pleural involvement / right pleural effusion

The cancer had a partial response to albumin-bound paclitaxel, carboplatin, and camrelizumab; camrelizumab was stopped after suspected immune-related pneumonitis, pulmonary embolism, and reversible pulmonary bullae, which improved after methylprednisolone was resumed.

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Stage IV sigmoid colon cancer: recurrence after FOLFOX, hepatectomy, and colectomy

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: Mismatch repair proficient; microsatellite stable; KRAS wild-type; BRAF wild-type; CEA 3.8 ng/mL at diagnosis

Metastatic Site: liver, lung

As of September 2025, metastatic sigmoid colon cancer had recurred in the lungs and remnant liver after initial FOLFOX, hepatectomy, and colectomy, requiring FOLFIRI plus cetuximab.

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Aggressive SMARCA4-deficient gastric cancer with rapid liver metastases after surgery

Patient Info: Anonymized, Female, 70+ | Stage IV

Biomarkers: SMARCA4 loss; SMARCA4 frameshift mutation

Metastatic Site: liver

Multiple liver metastases appeared within 1 week after surgery. She received 1 chemotherapy cycle but could not continue because of poor condition and was transferred for hospice care.

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Stage IV EGFR Lung Cancer: Emily's Patient Story

Patient Info: Emily, Female, 40s | Stage IV

Biomarkers: EGFR mutation

Metastatic Site: Right lung; right 8th rib; sacrum; pancreas; brain

Emily had Stage IV EGFR-mutated lung cancer treated with daily targeted therapy, 4 rounds of chemotherapy, and later radiation. As of September 2025, she felt well and described being almost/basically in remission, but her cancer remained treatable rather than curable and she continued daily targeted therapy.

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Stage IV HER2-Positive Non-Small Cell Lung Cancer: Lauren's Patient Story

Patient Info: Lauren, Female, Under 40 | Stage IV

Biomarkers: HER2 mutation

Metastatic Site: Bones/ribs/shoulder; liver

As of September 2025, after about 4 months of targeted therapy, Lauren reported better quality of life, resolved bone pain, improved liver pain, improved liver enzymes, and manageable infusion-week side effects.

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Rare soft-tissue sarcoma: surgery and multimodal treatment

Patient Info: Anonymized, Female, 60s | Stage IV

Biomarkers: Pathogenic BRIP1 c.1871C>A mutation found in tumor and germline testing; vimentin positive, SMARCB1/SMARCA4 preserved.

Metastatic Site: lung, left hilar lymph node

As of September 2025, she had sustained complete oncologic remission for 36 months after starting olaparib 300 mg twice daily for BRIP1-mutated metastatic undifferentiated pleomorphic sarcoma.

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Stage IV BRAF Colorectal Cancer: Jackson's Patient Story

Patient Info: Jackson, Male, Under 40 | Stage IV

Biomarkers: BRAF mutation

Metastatic Site: Liver; peritoneal wall

Jackson had Stage IV BRAF-mutated colon cancer with extensive liver disease and later confirmed peritoneal-wall tumors. His treatment response was strong, with about 90% of liver disease estimated gone, but he remained on active treatment with possible future HIPEC evaluation. As of September 2025, he was responding well but not cancer-free.

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Stage IV ALK Lung Cancer: Shauna's Patient Story

Patient Info: Shauna, Female, 50s | Stage IV

Biomarkers: ALK-positive

Metastatic Site: Both lungs

Shauna had Stage IV ALK-positive lung cancer involving both lungs. She was stable for about 5 years on her first TKI, had radiation for limited lung growth, and later switched to a newer TKI with stable scans. She explicitly said she had never had no evidence of disease, so the record should not be labeled NED.

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Stage IV Triple-Negative Breast Cancer: Melissa's Patient Story

Patient Info: Melissa Fouts, Female | Stage IV

Biomarkers: ER-negative; PR-negative; HER2-negative

Metastatic Site: Outside the lungs / pleural area

As of September 2025, Melissa had been on low-dose eribulin for almost 7 years; 6 metastatic nodules outside the lungs had shrunk and stabilized, with 3 nearly undetectable on scans.

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Stage IV Colorectal Cancer: Laura's Patient Story

Patient Info: Laura VanBrocklin, 40s | Stage IV

Metastatic Site: liver

After multiple procedures and surgery for Stage IV colorectal cancer with liver involvement, Laura was still finishing chemotherapy.

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Stage IV Colorectal Cancer: Heather's Patient Story

Patient Info: Heather Candrilli, Female, Under 40 | Stage IV

Metastatic Site: Liver

Heather had Stage IV colon cancer with liver-only metastases. Her scans improved and Signatera became negative, but she still had many liver lesions and was not considered resectable. As of September 2025, she remained on chemotherapy while pursuing living-donor liver transplant evaluation.

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Stage IV lung adenocarcinoma with brain and right shoulder-joint metastases: durable pain relief after SBRT

Patient Info: Anonymized, Male, 70+ | Stage IV

Metastatic Site: brain; right shoulder joint

Right shoulder pain resolved within 1 week of SBRT, PET/CT at 6 months showed no FDG uptake in the joint, and there was no right shoulder pain recurrence at the final examination 9 years and 3 months after SBRT.

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Stage IV transverse colon cancer with NTRK fusion: entrectinib response followed by fatal PTTM

Patient Info: Anonymized, Male, 70+ | Stage IV

Biomarkers: RAS/BRAF wild type, low TMB. CEA and CA19-9 were elevated before entrectinib and fell with response.

Metastatic Site: peritoneum, greater omentum, pleura,…

He died 7 weeks after hospitalization from pulmonary tumor thrombotic microangiopathy causing severe pulmonary hypertension and right-heart failure, despite biochemical and ascites response to entrectinib.

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Stage IV Breast Cancer: Maria's Patient Story

Patient Info: Maria, Female | Stage IV

Metastatic Site: Bone (spine, clavicle, rib, thigh bone, scapula);…

Maria initially had a clean PET scan after chemotherapy, surgery, radiation, and targeted/endocrine therapy, but later developed Stage IV metastatic breast cancer involving multiple bone sites, with lung and cervical-region involvement also described. As of September 2025, she remained on treatment and did not have an available clinical trial option.

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Stage IV ALK Non-Small Cell Lung Cancer: Steven's Patient Story

Patient Info: Steven Huff, Male, Under 40 | Stage IV

Biomarkers: ALK-positive

Metastatic Site: Lungs; liver; spine; sacrum; chest lymph nodes;…

Steven had Stage IV ALK-positive NSCLC and responded well to twice-daily oral targeted therapy, with several years of stable scans and a return to teaching and family life. As of September 2025, he remained on active treatment rather than being cancer-free.

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